How to perfect a complete digital manufacturing process to create top-quality removable dentures

August 3, 2020
Eric D. Kukucka DD, Canada
Volume 42, Issue 2

Ivoclar Vivadent’s Ivotion Digital Denture Innovation works with 3Shape to allow patient-specific customization and great results.

WHAT IS AN INNOVATION?
Innovation is defined as the introduction of something new, a new idea, method, or device. For Ivoclar Vivadent, to further qualify a product as innovative, it must also be easy and very efficient, require fewer clinical appointments, fewer manual working steps, appealing esthetics, individual and functional dentures, ability to shape and morph the teeth, highly efficient manufacturing, and high-quality optimal results for the patient.

“Disruption” is a word you tend to hear quite a lot these days, especially in the digital economy. Contrary to the word’s negative connotations, when disruption leads to improvement, it’s actually a positive.

Disruption is a process in which existing ways of doing business (products, technologies, services) are replaced and sometimes driven out of use by new technologies. Two examples of disruptive innovations are Uber, which changed the conventional taxi industry, and Netflix, which has rendered traditional video stores virtually obsolete.

Digital Dentures

The Digital Denture Process is an excellent example of disruptive innovation to digital dentistry and as a whole has evolved over the past five years with more than 1,000,000 cases designed in 3Shape Dental Systems. This is no longer a concept, but a ground breaking reality.

Conversely, only 1% of the removable prosthetics manufactured globally are digital. In 2019, 3Shape saw a 250% growth in the number of digital dentures designed. That statistic bears repeating: 250%!

What does all this mean? Earlier I spoke about morphing: so what happens when a company like Ivoclar Vivadent meets innovation? The result: Ivotion. One disc. One milling process. One denture.

Combining proven high-quality tooth and denture base materials in a single bi-color disc, Ivotion provides digital dental laboratories with an efficient, predictable, monolithic milling solution that offers change in the world of digital dentistry, the kind of change that will most certainly be noted in the history books of prosthetics as a pivotal turning point.

The driving factor behind this innovation was to make the production of digital dentures as efficient as possible for a laboratory. And what could be easier than to get a finished denture out of one single disc?

The Ivotion monolithic milling disc features unique Shell Geometry, a data-based three-dimensional tooth and dental arch structure suitable for the rapid digital fabrication of removable upper and lower dentures. It is based on the data of time-tested complete dentures to create this geometry. Shell Geometry defines the transition between the tooth and the denture base sections of the disc.

Integrated exclusively into 3Shape Dental System 2020 CAD software, the digital denture system allows patient-specific customization with the Ivotion tooth library and the coordinated Shell Geometry. Efficient design strategies offer the freedom to customize and morph the shape of individual teeth for optimal retention, stability, function, phonetics, and esthetics.

What makes this process a true innovation is the elimination of the denture tooth bonding process. Dentures are milled in the PrograMill milling unit in one uninterrupted milling process and only need application of surface texture, separation, and polishing prior to delivery—true to the motto that Ivoclar Vivadent has declared: Design. Mill. Finish. Ivotion is the answer to optimal efficiency, as customized monolithic complete dentures are fabricated in a seamless workflow with fewer manual working steps.

Regardless of your clinical record process, the Ivotion Digital Denture Process is designed to provide you with exceptional quality, and a clean, esthetic result that can be digitally preserved indefinitely. Throughout this article I will demonstrate a unique 3-appointment clinical process as well as the laboratory design, mill, and finish process.

Clinical Procedure

Clinical Record options for centric relation records can include occlusal rims, existing denture impressions (reference dentures), Gothic arch tracing with functional final impressions, as well as a unique workflow, that includes two impressions and a centric tray which will be shown in greater detail in the article below (Figs. 1-3).

Preliminary Records utilizing Accudent XD, UTS CAD Fixated to Centric Tray to determine Bi-Pupillary Line & Campers Plane (Figs. 4-5).

Laboratory Procedure

The scanning of the Centric Tray with the 3shape Impression Fixture is shown in Figure 6. Scanning of the Centric Tray and Maxillary and Mandibular Impressions are illustrated in Figure 7. Maxillary and Mandibular impression scans are then aligned to the Centric Tray Scans (Fig. 8).

Maxillary and Mandibular mounted casts with Centric Tray Registration and the UTS CAD in the 3Shape software (Fig. 9).

Model Analysis, denture base outline, and Initial Proposal of Ivotion (Ivoclar Vivadent) follows, and the arch proposes based on the occlusal plane established by the UTS CAD. The Arches can be arranged with either a Soft or Bold Tooth Mould Utilizing the Phonares II Moulds B and S 70 Series from Ivoclar Vivadent. This mould features slightly abraded incisal edges and a reduced facial curvature but can be morphed and individualized to meet esthetic specifications (Fig. 10).

The laboratory does an evaluation of the Ivotion Full arch arrangement proposal, an evaluation of Shell Geometry and final Gingiva proposal (Figs. 11-12). Figure 13 shows the milling of the Try-in Pro Art CAD Try-in. The intraoral assessment of the Pro Art CAD Try-in (Fig. 14.) The Shell Geometry is demonstrated.

Note that the polymerization process occurs while the material is still in its “wet swelling state creating a true monolithic disc due to the unique polymerization process” (Fig. 15a-b).

The Ivotion Disc demonstrates one monolithic Disc, while the CAM V.4.1 illustrates seamless integration of the CAM5 Ivotion file into the CAM software. This nests the Ivotion Denture directly into the Ivotion disc aligned with the Shell Geometry.

The PrograMill PM7 performs the first milling steps of milling pink and white with 5 mm flattening tool (Figs. 16-17). Figure 18 demonstrates the monolithic disc being milled where the tooth arch begins to be defined, leading to the final results directly after milling (Fig. 19).

Final Results After Milling

Ivotion Digital Denture Innovation helps you produce optimal results. The finalization steps include separation, individualization vertical and horizontal surface textures (Fig. 20a-c).

Next, polish surface texture and interproximals with Universal polishing base. Polish the denture base with Resilience Pumice and 3 brushes for optimal smooth and polished surfaces, and finalize with Universal Polishing Paste leading to the desired appealing esthetics, individual and functional dentures and high-quality optimal results for the patient (Fig. 21a-c).

With Ivotion, customized monolithic complete dentures are fabricated in a seamless workflow with fewer manual working steps. The workflow makes it easy for clinicians to implement and to get great results.

Regardless of your clinical record process, the Ivotion Digital Denture Process is designed to provide you with exceptional quality, and a clean esthetic result that can be digitally preserved indefinitely (Figs. 22-23).

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